Child Can Get Irritable Bowel Case

February 07, 1986|By G. Timothy Johnson, M.D.

Dear Dr. Johnson: Can children get the irritable bowel syndrome that adults have? If so, does a higher fiber diet help them?

Many pediatricians feel there is an equivalent in children to the so-called irritable bowel syndrome in adults that they sometimes refer to as recurrent abdominal pain (RAP). And, as with this kind of problem in adults, some studies suggest that an increased fiber diet could be helpful in children who have recurrent abdominal pain for which no specific underlying cause can be found.

Before anyone--adult or child--goes on a dramatically increased fiber diet for abdominal complaints, the problem should be reported to a doctor to make sure there is not some other problem--and to make sure that an increased fiber diet makes sense and is done so wisely.

Dear Dr. Johnson: Are vitamin B-12 shots a legitimate way to treat fatigue?

Usually not. Vitamin B-12 should be given only when there is good evidence from precise tests of a vitamin B-12 deficiency, which in turn leads to the condition known as pernicious anemia.

Vitamin B-12 can be lifesaving when pernicious anemia exists, but it can be a waste of time and money when it is given for no good reason.

Unfortunately, many physicians have over the years succumbed to the temptation to give vitamin B-12 shots as a way of ``placebo`` (nonactive) treatment for people complaining of fatigue.

It may help such people because of the placebo effect (meaning the individual`s condition improves despite the absence of any real treatment), but it is not good medicine, and it may lead to problems that would not have to occur.

Dear readers: Minority doctors have heeded the call.

The Dec. 12, 1985, issue of the New England Journal of Medicine contains an important article suggesting that minority physicians have fulfilled some of the objectives hoped for them in terms of care for minorities.

A study of medical school graduates in 1975 indicates a larger proportion of minority graduates chose primary care specialties, as well as practices and locations designated as health-manpower shortage areas. They also have more Medicaid recipients in their patient populations than do nonminority graduates.